A new study states a third of patients who receive total knee replacement surgery do not actually need the operation. Researchers reviewed medical data on 175 patients, and after assessing their information such as knee arthritis, pain and stiffness in the joint, found 60 of the patients, or 34 percent, were not good candidates for the surgery, Modern Healthcare reported.

"Approximately a third of TKA (total knee arthroplasty) surgeries were judged to be inappropriate," the study said. "...These data support the need for consensus development of criteria for patient selection among practitioners in the US treating potential TKA candidates."

According to the National Institutes of Health, knee replacement surgeries are intended for those with severe knee damage - that which makes it hard or painful for a person to walk. Researchers in the study created a classification system to evaluate pre-operation patient data and found patients 55 and over who experienced significant knee pain, knee osteoarthritis and functional loss of the knee were the best candidates for the surgery, Modern Healthcare reported.

Despite the NIH's recommendation for when knee replacement is appropriate, a third of the patients included in the study experienced slight or moderate symptoms but still received the knee replacement.

"It seems reasonable to question whether TKA was the most appropriate intervention," study authors Daniel Riddle, Dr. William Jiranek and Dr. Curtis Hayes of the departments of physical therapy, orthopedic surgery and radiology at Virginia Commonwealth University in Richmond, said. "Most of these subjects either had pain and functional loss profiles that were less than half that of typical patients undergoing TKA or they had no joint space narrowing."

Number of knee replacements increasing Approximately 719,000 total knee replacement surgeries are performed every year in the United States, according to data from the U.S. Centers for Disease Control and Prevention. That is more than the number of surgeries conducted to fix or repair a fracture or dislocated bone, more than total hip replacement surgeries and higher than the number of hysterectomies performed annually.

A previous study published in The Journal of Bone and Joint Surgery showed the number of total knee replacement surgeries more than tripled between 1993 and 2009, Modern Healthcare reported. That study also attributed the rise in overall primary joint replacement surgeries to the growing population of overweight and obese people.

Dr. Jeffrey Katz from the Orthopedic and Arthritis Center for Outcomes Research at Brigham and Women's Hospital in Boston, told Modern Healthcare physicians need to talk to their patients about all the risks and benefits of having a total knee replacement.

"This discussion is complex but seems the most appropriate course given the current state of play," he said.

The views expressed in this document are solely the views of the author and not Martindale-Hubbell. This document is intended for informational purposes only and is not legal advice or a substitute for consultation with a licensed legal professional in a particular case or circumstance.

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